Job Title:
Case Mgr-Transition Navigator
Job ID:
Ross Heart Hospital
Clinical Case Mgmt - Ross
Full/Part Time:
FTE %:
Salary Range Min:
Salary Range Max:

Position summary

Case Mgr-Transition Navigator (Job Opening 436283) - Scope of Position/Position Summary: The Transition Navigator facilitates an assigned group of patients who are identified as at high risk for readmission through the health care system. The primary focus is on the coordination and delivery of efficient, effective, compassionate inpatient care and a safe transition to the outpatient setting including post discharge coordination of care. The Transition Navigator monitors the patient care process and physiological needs; educates, documents, communicates, and collects data to evaluate and assure patient/family readiness for discharge. The Transition Navigator facilitates the lateral integration of the care team, collaborating with physicians, nurses and other staff to provide comprehensive disease management, assessment, treatment, education, and follow-up evaluation for patients; and, to communicate the plan of care in coordination with post acute care settings.

Education and experience

Masters prepared Registered Nurse preferred. Five years of recent clinical experience applicable to the population preferred; knowledge of evidenced-based practice and disease specific processes; knowledge of technology and payer protocols desired. Case management or home care experience preferred.